WATERBURY PSYCHIATRIC ASSOCIATES, P.C.
Ambulatory Health in Waterbury, CT

License number
Connecticut 042814
Category
Ambulatory Health
Type
Adult Mental Health
Owner
Name: AZHAR IMAM M.D.
Title: PRESIDENT
Phone: (203) 597-0575
Address
Address
133 Scovill St Suite #201, Waterbury, CT 06706
National Provider ID: 1316161193
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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WATERBURY PSYCHIATRIC ASSOCIATES, PC

133 Scovill St STE 201, Waterbury, CT 06706

Status:
Inactive
Registration:
Dec 27, 2006
State ID:
0883231
Business type:
Stock
PRESIDENT:
Azhar Imam (PRESIDENT), 108 Talmadge Rd, Cheshire, CT 06410 (Mailing)
Agent:
Azhar Imam, M.d,133 Scovill St STE 201, Waterbury, CT (Mailing)
475 Higgins Rd, Cheshire, CT 06410 (Physical)

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